Commotio cordis and L-type calcium channel mutation: Is there a link?

Pacing Clin Electrophysiol. 2019 Oct;42(10):1411-1413. doi: 10.1111/pace.13739. Epub 2019 Jul 2.

Abstract

Commotio cordis is a rare phenomenon when ventricular fibrillation and sudden death occurs with a blunt, nonpenetrating blow to the chest. Individual susceptibility to commotio cordis has been demonstrated in swine models, and might be present in humans as well. We report a case of commotio cordis in an adolescent with a heterozygous mutation on the gene CACNA1C, encoding for an L-type calcium channel expressed in the heart. This genetic mutation has been previously associated with a phenotype of long-QT syndrome; however, this was not demonstrated in our patient despite extensive investigations. To the best of our knowledge, this is the first report of commotio cordis in which an ion-channel gene mutation involved in repolarization abnormalities has been documented. This finding might corroborate the hypothesis that a genetic predisposition plays a role in the individual susceptibility to this rare cause of cardiac arrest.

Keywords: cardiac arrest; commotio cordis; gene; sudden cardiac death; ventricular fibrillation.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Calcium Channels, L-Type / genetics*
  • Cardiopulmonary Resuscitation
  • Commotio Cordis / etiology*
  • Commotio Cordis / therapy
  • Echocardiography
  • Electrocardiography
  • Exercise Test
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Mutation
  • Ventricular Fibrillation / etiology*
  • Ventricular Fibrillation / therapy
  • Wounds, Nonpenetrating / complications*

Substances

  • CACNA1C protein, human
  • Calcium Channels, L-Type